WHITWELL MEDICAL PLAZA


Address: 13851 Highway 28, Whitwell, TN 37397-5373
Phone: 4236589200

WHITWELL MEDICAL PLAZA (NPI# 1225409147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1225409147
Entity Type Organization
Organization Name WHITWELL MEDICAL PLAZA
Other Organization Name JUNG TAE PARK
Practice Address 13851 Highway 28
Whitwell
TN 37397-5373
Mailing Address 13851 Highway 28 Po Box 400
Whitwell
TN 37397-5373
Practice Telephone 4236589200
Practice Fax Number 4236582195
Mailing Telephone 4236589200
Mailing Fax Number 4236582195
Enumeration Date 2015-10-19
Last Update Date 2017-11-01
NPI Deactivation Date 04/18/2016
NPI Reactivation Date 2017-10-05
Authorized Official Name JUNG TAE PARK (MD-OWNER)
Authorized Official Telephone 4236589200
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2300X Clinic/Center
Specialization: Primary Care
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Jung Tae Park Doing Business As Name - Organization

Office Location

Street Address 13851 HIGHWAY 28
City WHITWELL
State TN
Zip Code 37397-5373

Providers in the same location

NPI Name Taxonomy Address Enumeration
1942291638 Jung Tae Park Family Medicine 13851 Highway 28, Whitwell, TN 37397-5373 2005-11-02
1356745848 Kimberly Gean Redfearn Nurse Practitioner 13851 Highway 28, Whitwell, TN 37397-5373 2014-10-13
1083982243 Brenda Ross Md PC Family Medicine 13851 Highway 28, Whitwell, TN 37397-5373 2011-12-02

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1760972202 Specialized Behavior Solutions Behavioral Analyst 360 Looneys Creek Dr, Whitwell, TN 37397 2018-05-10
1134285125 Frederick Kirk Mcdermott Counselor 13810 Hwy 28, Suite B, Whitwell, TN 37397 2006-12-28
1295811156 Hooper Drug Store Pharmacist 325 E. Spring Street Po 129, Whitwell, TN 37397-0129 2006-10-31
1477627768 Whitwell Pharmacy Inc Pharmacy 13810 Highway 28, Whitwell, TN 37397-5365 2006-11-20
1689961104 Whitwell Senior Living, LLC Assisted Living Facility 13960 Highway 28, Whitwell, TN 37397-5366 2011-07-05
1043271091 Nonie Ivey Linder Social Worker 720 Teague Rd, Whitwell, TN 37397-5982 2006-03-29
1447471909 Ingrid Rene Long Registered Nurse 295 Scissomtown Rd, Whitwell, TN 37397-6601 2007-05-01
1083228209 Tarrah Davis Nurse Practitioner 205 Fiddlers Dr, Whitwell, TN 37397-8918 2020-09-04

Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

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1831724822 Guiding Star Memphis Clinic/Center 2980 Poplar Ave Ste 101, Memphis, TN 38111-3527 2020-03-10
1407486764 Elijahs Dream Compassionate Care Clinic/Center 134 Creekside Dr Ste 1, Ocoee, TN 37361-3653 2020-01-24
1518506542 Faith Medical Group, Pllc Clinic/Center 500 Mcfarland St Ste E, Morristown, TN 37814-3992 2019-12-20
1366080582 Matthew E. Schantz, M.d. Clinic/Center 206 S Military St Ste 1, Loretto, TN 38469-2101 2019-12-18
1114563749 Step One Medical Associates PC Clinic/Center 4502 Bristol Hwy, Johnson City, TN 37601-2936 2019-11-19
1023665403 Elite Healthcare, LLC Clinic/Center 117 N 3rd St, Kingston, TN 37763-2842 2019-08-21
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Competitor

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City WHITWELL
Zip Code 37397

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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